Endometriosis Awareness Endometriosis can only be definitively diagnosed by a laparoscopy

The Only Way To Definitively Diagnose Endometriosis Is Via Surgical Intervention–

The only way to definitively diagnose endometriosis and the causes of period pain is via surgical intervention. Scans, blood tests etc do not diagnose endometriosis. You cannot have a scan to diagnose endometriosis and you cannot have a blood test to diagnose endometriosis either.

The definitive diagnosis of endometriosis needs to be done via a laparoscopy

The definitive diagnose IS and ALWAYS WILL BE via a laparoscopy/laparotomy, along with histology (biopsy) and tissue samples taken to examine. Most times a hysteroscopy is done at the same time and if there is an evaluation for fertility, dye studies for tubal patency will be done at the same time.

Women with endometriosis need to see an Advanced Trained Laparoscopic Surgeon

A laparoscopy is the goal standard investigation of examining the pelvis and for investigating gynaecological disorders such as endometriosis. The laparoscopy also needs to be done by what we call an Advanced Trained Laparoscopic Surgeon, who has extra years of surgical training, and who specialises in this disease and specialises in the excision of endometriosis.

It can’t just be done by a regular obstetrician/gynaecologist and this is where many go wrong. Many women just haven’t seen the right surgeon first up who has he proper skills to deal with endometriosis effectively. The first surgery should always be your best surgery and early intervention and management of this disease is crucial. The longer it is there, the worse it can become.

Ultrasounds and Bloods Tests etc Cannot Diagnose Endometriosis

All too often I get women telling me that they do not have endometriosis because their doctor has ruled it out via an ultrasound, or blood test. This is so distressing to hear and this is why so many women are missed and dismissed with this horrible disease that affects 1 in 10 women world wide.

Endometriosis Management Requires a Multi-modality Approach

But, please know that surgery does not cure endometriosis. It is just the first stage in the management of the disease and the active lesions that have been expressed and are present now. Endometriosis can, and will return for many suffers and this is why endometriosis needs ongoing care and a multimodality approach to treat it effectively. It needs a team to manage it properly. While surgery is an important part of evaluation, management and diagnosis of endometriosis, it is to help with symptomatic pain and then other treatments are needed to suppress the disease from further developing and also managing ongoing symptoms.

If you need help with period pain, or  assistance with endometriosis, please give my clinic staff a call and book in a consultation.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

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Endometriosis Awareness Month March 2019

Dr Andrew Orr has an honest and open talk about Endometriosis Awareness Month and also about the disease itself.

Dr Andrew Orr talks about the facts, the myths and what women with endometriosis go through on a daily basis.

He also discussed that there is help out there and what is needed in a multi-modality (team like) approach to care and ongoing management of the disease

Lastly, he wants every women, and man, to know that Period Pain IS NOT Normal and that women do not need to suffer in silence. There is always help out there and you just have to find the right people who will care, listen and help you in every aspect that you need.

Dr Andrew Orr has a special interest in Endometriosis and does research and lecturers about this horrible disease that affects 1 in 10 women world wide. If you do need help with period pain, or endometriosis and the associated symptoms, please give his clinic a call. Please do not suffer in silence alone. There is help out there. Dr Andrew Orr’s motto is “No Stone Left Unturned” and he uses this to assist all his patients.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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Sometimes The Body is Like a Well Sprung Spring & Other Times Not

Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.

As everyone knows, I always use a very integrative medicine/ multi-modality approach to treating people and getting the best for people’s health. I always believe that preventative medicine is the best approach to any health problems, but sometimes medical intervention, in the form of surgery,  is needed for some acute complaints.

It is always hard when someone comes into the clinic and they are doubled over in acute pain from endometriosis, or an acute skeletal issue, and while I can help them, I know that the best thing for their long term health would be intervention in the form of surgery. That is not saying I cannot help and assist people with acute pain, but sometimes the best thing to do is get the person in for surgery to help with the acute pain, and then follow up with preventative and rehabilitation care.

Often it can take several months to help regulate hormonal issues and pain from conditions such as endometriosis, or pelvic inflammatory disease, with more conservative forms of treatments such as pharmaceutical medicines and hormones, complementary medicines, acupuncture, supplements etc. While the outcome after treatment is always great, is it really beneficial for people to endure constant pain for months, when surgery could produce a faster result, for the pain?

In saying that some of these conditions have a high rate of return, so that is where an integrative medicine/multi-modality approach can help post surgery.

I was talking to a medical specialist last week, who promotes complementary medicine for all his patients, and he explains it to his patients like this; “Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.”

I see people in my clinic just like this spring. Some are well oiled, and well sprung, and bounce back into shape very quickly. Some are showing the signs of starting to lose their spring, and then others have just pushed their body to the point or no spring, or worse still to the point of non-repair. Obviously I like seeing people do the right things and use preventative health so that they stay well oiled and well sprung. I do like to see people coming into the clinic when they get the first signs of ill health and the spring is starting to recoil slowly.

The sooner you get onto any health complaint the easier it is to treat. Early intervention is the key to any disease state, or health issue. But, we all know people who push through pain and say “She’ll be right mate” and get to that point where they just can’t recoil anymore. Then we get the ones that have gone beyond that and unfortunately no matter what they do you will never be able to get them back to what they used to be like. So, please don’t ever let your body get to this point if you can.

The reason for this blog was to not only inform people to be proactive with their health but to also make sure people are covered if they do need surgery. It is always such a shame and I always feel sorry for people who need urgent medical attention, but they don’t have private health cover. I know that not everyone can afford it, and I am not pushing it either. But, it is worth considering for anyone who have a long term health issue, or especially for women trying to conceive.

Every woman is going to need to see a gynaecologist at some stage in their life and you don’t want to be relying on a failing public health system that could have you waiting months, or even years, for an appointment, or much needed surgical intervention. Those experiencing fertility issues will need some investigation at some stage so it’s almost necessary to be prepared and well covered.

I’ve seen so many people over the years that come into my clinic, for so many different ranges of acute conditions, that actually do require some sort of urgent surgical intervention, but only to find out they can’t get the necessary treatment they need because they aren’t covered.

The public health system is in such a mess at the moment and wait times are becoming increasingly long. If you have an acute condition, you don’t want to be waiting months, or years for treatment. The other issue is that you don’t get to see a surgeon of your choice and can then end up with the lucky dip of whomever is there on the day. The other issue is that this person may not specialise in the disease state, or issue you are there to have treated. This is what happens to many and this can then have long term health consequences if you aren’t given the right care that you need, or they actually miss crucial issues as well. It is a big issue.

Then when you finally get to having the surgical intervention, it may require multiple surgeries, and the first surgery may be just for investigation only. I’ll give you an example. I had a friend, with acute period pain that got nausea, vomiting and even fainted, (from severe endometriosis) go on a 12 month wait list for surgery in the public system. Finally she got in for surgery only to wake up and find that the operation was one of many to come and the first one was only for investigation purposes only. She would need ‘three’ more surgeries spaced at months apart. So nothing was done with the first surgery, she was still in pain and now had to prepare for further surgeries.

Yet, a similar friend who had a private cover, got to chose the gynaecologist of her choice, got someone who specialised in her disease state, was an advanced trained excision surgeon, had no wait time, had not out of pocket expenses, had everything tidied up and the endometriosis removed on the first surgery. This same lady could then come back to see me straight away to prevent the endometriosis from returning and was now not getting that acute pain anymore. There is a huge difference in the time, the surgeon who this the surgery, the treatment and the amount of surgery needed.

As I said, it is a hard topic to talk about and is by no means a push for private health cover. I am only talking about this to educate people that sometimes it may be a necessary part of your overall health. It just distresses me seeing people who need desperate immediate help, not being able to get it. I know that not everyone can afford it and believe me you have to shop around when you do start looking at it. The big companies are usually the worst to deal with and the smaller companies are usually the best to deal with, and give you better rebates.

In saying that, private health is a sometimes necessary part of overall health care, especially for those with ongoing health concerns and especially those that may require some form of medical intervention. There are some great smaller funds out there that don’t cost that much and give you full hospital cover with an outlay of a couple of dollars per day. You can also look into having extra’s cover as well, which will cover part of the treatments with us also.  Again some of the smaller funds provide better rebates and the best thing would be to give us a call and we can tell you who those funds are. I hate talking about these sorts of things but at the end of the day I care when people aren’t getting the right help and am here to help people with every area of their overall health. It is a very important issue that we all need to consider and that we all need to discuss too.

If you do need help with pain, or  any health condition, or need someone who cares and can help you get the right advice and health management, please give my clinic staff a call. Just book in an initial extended consultation and let’s get you feeling like you again.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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Asking the Right Questions about Period Pain & Gynaecological Issues.

All to often women have gynaecological disease states “missed” and “dismissed” because their healthcare practitioner was not asking the right questions about period pain and gynaecological issues.

I didn’t know how I was going to start this post, or begin to talk about what I am about to talk about, other than I got some inspiration after a text message, and a phone call later on,  from my eldest daughter some time ago.

I will talk about that soon. But let’s talk about some of the phone calls and messages I get from people every day and how some of these messages gives me a heads up into what may be going on for these people and then getting them in for a proper consult and the right help.

Every day I get phone calls, emails, Facebook messages etc, from women (young and older) who are experiencing period pain, menstrual issues, and other related symptoms and nearly all of them have the same story.

“I have been to the GP and I have had blood tests and scans and they say that there is nothing wrong”. This is what I hear all so often.

It happens so often and it is like there is a script written for these poor women who just want to get out of pain and get some sort of normal life back. I get so annoyed when I hear this repetitious line. Not at the people telling me, but knowing that these poor women really haven’t been investigated properly at all and probably won’t be unless they come and see me.

I remember I got a text that I really wasn’t expecting, as it was from my eldest daughter.

It read “Hey Dad, is endometriosis hereditary?”

To which I replied “Yes it can be, why?”

I anxiously awaited the next reply and thankfully she was asking on behalf of a friend. But this poor friend had been experiencing really bad period pain and had basically had blood tests and scans and been told that everything was normal.

Apparently one of the scans showed some fluid in the Pouch of Douglas (POD), which can actually be a sign of endometriosis and inflammation. Worse still, this poor girl’s mother actually has endometriosis and nobody is putting two and two together and asking the question “I wonder if the daughter may have it too?”

Well, there is more than a good chance that she does have it and thank goodness my daughter actually knows the signs and knows that scans and bloods tests cannot diagnose many gynaecological issues, especially endometriosis.

Lucky my daughter also knows that you need to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis and has done years of extra surgical training to specialise in these disease states. The good thing is that she knows that you cannot just see a regular gynaecologist to get this done.

But, not everyone is as fortunate as my daughter to know this and help her friend to come and see me to help her see my surgeon and then I can help her with management of the disease, if found (which is highly likely) after the surgery.

The other good thing is that my daughter knows there is no cure for endometriosis and that surgery isn’t going to fix the problem either. She knows it will help, and is needed, but after the surgery, the management post surgery is the most important, for disease states like endometriosis.

Unfortunately not many people know this and don’t have the disease managed properly post surgery. Women with endometriosis and some other inflammatory gynaecological issues will need a team approach, or a multimodality approach  post surgery, because even with the best medical intervention, it really isn’t enough and why so many women have the disease and symptoms return, or may still be in pain and have other recurring symptoms.

There is never a one treatment, one pill, fix all approach to disease states such and endometriosis. This is where so many go wrong.

One of the main issues for women can be that they really have not seen the right healthcare professions, especially the right surgeon and unfortunately this is many of the women that have had surgical intervention. This one is so important.

Whenever I get messages from women in pain, or I consult with women who have period pain and all the other associated symptoms, there are some standard questions I ask, to know if they have been given the right information, been diagnosed properly, or seen the right surgeon.

  1. I always ask “what tests have you had done?” – I know that if they have only had blood tests and some scans, then these women have not been investigated, or diagnosed properly.
  2. Then I usually ask “Have you just seen your GP, or have you seen a specialist?”– Most of the time many women have not been referred onto a specialist and have only just been seen to by a GP. This is one of the biggest issues women face when it comes to gynaecological conditions. GP’s are just general practitioners. They are not gynaecologists and definitely not advanced trained laparoscopic surgeons. The best thing any woman can do is ask for a referral to a specialist and a good GP should know to do this anyway. This is one of the biggest reasons that women from all over the world take up to a decade to be diagnosed with disease states such as endometriosis. On a daily basis women are missed and dismissed and told there is nothing wrong, go on the pill, or that they have some inflammatory bowel condition, when in fact they have endometriosis, or adenomyosis, or some inflammatory gynaecological issue. Btw, this isn’t to put GP’s down, unfortunately this is what happens to so many women and why it often takes up to a decade for women to be diagnosed with diseases such as endometriosis. This is an unfortunate fact and it needs to change.
  3. Then I ask “Have you had a laparoscopy?”– One of the most common responses is “What is a laparoscopy?” and that way I know they haven’t had one done. A laparoscopy is the gold standard investigation of the pelvis and the only way to properly diagnose disease states and causes of period pain, such as endometriosis.
  4. If the woman has had surgery I then ask “was the surgery done publically, or privately?” – This will tell me a few things. It will let me know if it was just done be a public surgeon, who probably isn’t an advanced trained laparoscopic surgeon. The issue is that there really aren’t that many advanced trained laparoscopic surgeons that do public work, and even if you strike the jackpot and do happen to get one, there is a good chance they are only in a teaching role to instruct a trainee surgeon to do the surgery anyway. But mostly women do not get an advanced trained laparoscopic surgeon in the public system. It is sad, but true unfortunately. Many times the first surgery in the public sector is purely investigative too and no excision (disease removal) is performed. This means that the woman has to come back for further surgery, or surgeries.
  5. If they the woman has had surgery done previously by a private specialist then I usually ask “Who was the surgeon that did your investigation and surgical procedure?” – Sometimes I can ask if the surgeon was an advanced trained laparoscopic surgeon and the patient usually will respond to not knowing, or even know what I was talking about. That usually gives me a clue that it most probably wasn’t, but then I can go and check the specialists qualifications online and see if they are, or most probably aren’t, an advanced trained laparoscopic surgeon who has done years of extra specialised surgical training.

All those 5 questions can tell me much about what some of these poor women have had done, or haven’t had done, and then I can formulate an appropriate treatment plan and management for these women moving forward. It is always hard explaining to the ones that have had surgery before that they haven’t seen the right surgeon and that they are going to need further surgery. The hardest thing for me is seeing women on support pages about to have their first surgery and I always worry that they aren’t seeing the right surgeon and if they don’t, there is a good chance that they are still going to be going through the same issues, over and over again, until they find the right person to help them. If only I could see all these women before they did anything, so that they can be given the right information and the facts and be managed properly.

The good thing is that when I do get to see women who chose to see me, I can explain to them the  facts and the right information and then why and how with a proper surgeon, that it can make a huge difference to how they are feeling and their recovery and management post surgery. I can also explain how surgery really is necessary, but is only a small part of their overall treatment and management of their disease moving forward. I can also explain the facts around their disease moving forward too and make sure that women under my care are given the right information, the right investigations and right management going forward.

This is why my initial consultations take about an hour and a half and we go over everything from their health history, medical history, hereditary issues, diet, lifestyle, surgical intervention, medications, natural medicines, blood tests, scans, investigations, sleep, sexual health, libido and everything that a woman needs to know about her particular issues.

It is also about listening to a woman’s concerns and complaints and really hearing what she has to say and is experiencing.

Then I formulate a treatment plan and management and 20 page report of findings for them for what we are going to be doing to help them moving forward.

I also give them a step by step treatment plan of treatments and medicines etc they will need too. That is why my motto is “No Stone Left Unturned”, because there is no stone left unturned and I also make sure they see the right people (surgeons and anyone else that they may need to see).

If there are things that I can’t do (surgery etc), I make sure that my patients only see the best people and then I can help manage the rest of their disease state for them.

I wish I could see every woman before they went for any investigation, or surgery, so I can point them in the right direction and help them manage their gynaecological condition properly.

This is why I am so passionate about doing my posts on social media, or giving time for charity events to talk about women’s health issues and gynaecological issues such as endometriosis, adenomyosis and PCOS.

It is why I do healthcare practitioner education and seminars to help educate them better too, so that they can help their patients better and not miss and dismiss them.

I just hope that I can help those who have not been heard and that have been missed and dismissed. I also hope we can get people to listen to the things I have presented above and also help women get a voice, be heard and get government listening and get more education to younger women too.

Lastly, I cannot say it often enough….. Period Pain “IS NOT” normal and if you, or your daughter, or your sister, or your mother, or cousin, your best friend, or anyone you know has period pain, especially bad period pain and other symptoms, please, please, do not tell them that this is normal.

It is not normal and they need to come and see me, or another healthcare professional who specialises in women’s health and gynaecological conditions, so that they can be investigated properly and have their issues managed properly too.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Care Advocate

-Endometriosis Experts

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Follow-Up Reply To Rust Never Sleeps & Neither Does Endometriosis

After my post on “Rust Never Sleeps and Neither Does Endometriosis” I was overwhelmed with such lovely messages from some amazing people

Wow, there really is so many people out there suffering this horrible disease. As I said, I had someone very special and dear to me that was riddled with Endometriosis and put up with it for 20-30 odd years. It was so bad and luckily I was able to help her get it sorted properly.

I help people with endometriosis everyday in my clinic. I know how it effects you physically, emotionally and on every level possible. It is such a terrible disease to have. I also know many people who have it don’t know they do have it until that start to try and have a baby. Then they come and see me and we find it. Many people are asymptomatic (no symptoms).

Unfortunately when it comes to endometriosis we really only hear about those who have the really have the bad pain. Unfortunately so many of you who have read this, or have contacted me about this, have the pain side of it.

But please take heart, you can beat this disease with the right treatment. I do know many of you aren’t seeing the right people, or not getting the right treatment for this. So many of you get overlooked, or passed over, or misdiagnosed, or even just plain old ignored. It is disgusting and should never happen

Endometriosis really does require a multi modality approach to treat it and help manage it properly though. There really isn’t one thing, or a magic pill. I wish there was. I wish I could give you all that. Through many years of studying this, years of treating this and just knowing what to do and what works and what doesn’t, is why I know this disease well. I do lots of things combined. I also have my own range of medicines that I have formulated to help assist in the treatment of endometriosis and other gynaecological issues. But they are practitioner only and do need to be prescribed by a qualified practitioner to be able to use them.

Even then you still just can’t take a magic pill. You really do need to look at the individual, assess that individual and then use a multi modality approach with everything from diet changes, lifestyle changes, help with emotions, help with the acute pain etc and really look at what is fuelling the pain and fuelling the endometriosis. The number one diagnostic and investigation for endometriosis and to help with acute pain will always be a laparoscopy too.

I do know it is hard for you all. I really do. Not everyone knows who to treat this properly and manage the symptoms properly as well. I wish they did. I really do. I know many of you have said you have tried everything and many times I find out your haven’t, or may have only just tried a few things in combination. You need to do it all properly and at the same time.

Some of you have really just seen the wrong people, been given the wrong advice and really just seen a crappy specialist, or surgeon. It really saddens me. So sorry for you that have. I really wish I could help all of you.

I do know many women who say they got relief from the hysterectomy and I have to say I sometimes have to tell people that only they can make this decision,  if it is really affecting your life. But I do need to let women know that hysterectomy ‘Does Not’ cure endometriosis. It will cure adenomyosis, but not endometriosis. Endometriosis is not in the uterus, so taking out the uterus is only going to help adenomyosis and also stop period related symptoms.

But if you are going to have a hysterectomy you need to know the facts and know that endometriosis will still be there.Sometimes the endo has really spread to other parts of the body so hysterectomy really doesn’t solve that at all.

If you are going to do any surgical intervention, it needs to be done by a good surgeon who is an adavanced trained laparoscopic excision surgeon. It also needs to be done intravaginallly and via laparoscopy. That is how I make sure my patients get it done. Sometimes that is not always possible, but when it is, that is the better option.The recovery is much better and there is less impact on them and their body. It is hard to make those decisions though.

It is hard to help from afar, but if you do want my help, I do Skype consults so I could help you. I do help people all over the world and Skype now offers a medium to do that.

I can’t give advice over the internet because of legal and professional ethical reasons, so I do need to see people, or at least Skype them to be able to give advice. It needs to involve a consultation.

It is so much easier if I can see you in person, especially those that live here in Australia. Flights are cheap these days and I have the best surgeons and team working with me. I really do have the best endometriosis surgeons as part of the team I work with.

I know how hard this must be for you, a very special loved one had very bad endometriosis as well. Luckily now, with the right treatment and after 30 odd years of getting nowhere, she is finally feeling better.

If you would like my help, please email me at info@shentherapies.com.au and also copy my patient liaison in at susan@shentherapies.com.au. That way it won’t get lost and I know she does get all my messages.

Please take heart. Know that you are not alone.Know that there really is help out there. I know this disease can be beat with the right treatment. Know that I hear you and what you are going through and will always be here to help educate people about this disease and hopefully find a cure to this horrible disease one day.

Looking forward to helping you if you need my help and pointing you in the right direction

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate